1. Field
In general, the inventive arrangements relate to medical systems, and more specifically, to integrating hemodynamic and imaging systems.
2. Description of Related Art
Hemodynamics involve the flow of blood in living animals. Factors influencing hemodynamics include, for example, CO, circulating fluid volumes, respiration, vascular diameter, resistance, and/or blood viscosity. Each of these factors may, in turn, be influenced by physiological factors, such as, for example, a person's weight, diet, exercise, health, sickness, and/or disease, as well as any medications, drugs, and/or alcohol that a person may be using. Understanding a person's hemodynamic condition often depends on measuring the person's blood flow at different points along the person's blood circulation.
Ultrasound, on the other hand, is, among other things, a diagnostic medical imaging technique, and it is often used to visualize, for example, muscles, tendons, and/or internal organs of a person. Other imaging techniques can include, for example, medical imaging equipment for general radiology, functional imaging, molecular imaging, vascular imaging, fluoroscopy, mammography, neurology, oncology, radio pharmacology, x-ray, computed tomography (CT), nuclear medicine (NM), positron emission tomography (PET), magnetic resonance imaging (MRI), and/or photoplethysmography. While the present inventive arrangements will be described in particular terms of ultrasound medical imaging, they are not limited in this regard.
Now then, previous hemodynamic and imaging systems are separate and disparate systems, as will be elaborated upon.
It is estimated that in North America and Europe, approximately 27 million people suffer from peripheral arterial disease (PAD)—which is also known as peripheral vascular disease (PVD) and/or peripheral artery occlusive disease (PAOD). It is often caused by the obstruction of large arteries in a person's arms and/or legs. PAD can often result from atherosclerosis, inflammatory processes leading to stenosis, an embolism, and/or thrombus formation. Often, it causes acute and/or chronic ischemia (i.e., lack of blood supply), often in a person's legs. Moreover, the prevalence of PAD in people aged over 55 years is approximately 10-25%, and it increases with age. Approximately 70-80% of affected individuals are asymptomatic, while others are symptomatic. Typical symptoms of PAD can include any of the following: calf pain in either or both leg(s), particularly while walking or running; painful sensations and/or tingling in the feet; or numbness and/or loss of feeling in a person's limbs (e.g., arms and/or legs).
As a result, early detection and monitoring of PAD is of growing importance, particularly in order to be able to provide early treatment to patients, including to general aging populations and older demographics, as is typical in many countries, including the U.S. In general, detecting PAD usually involves evaluating the arteries that supply blood to lower body extremities.
Upon initial suspicion of symptomatic PAD, a common first examination is used to determine a patient's ankle brachial pressure index (ABPI or ABI), which measures a fall in blood pressure in the arteries supplying blood to the person's legs, particularly relative to the person's arms. Ideally, ABPIs should be at least 1. Reduced ABPIs (e.g., less than 0.9) can be consistent with the on-set of PAD, while values of ABPI less than 0.8 can indicate moderate disease. ABPIs less than 0.5 can indicate severe disease. Such determinations are often referred to as “indirect” assessments, and they are conducted by techniques such as measuring a patient's blood pressure, segmental limb pressure, toe pressure, pulse volume readings (PVR), exercise stress levels, blood oxygen concentrations (aka oximetry and/or pulse oximetry), and/or cutaneous temperatures. Many of these tests are conducted in special environments, such as a doctor's office, hospital, and/or other medical facilities. The tests carried out by such hemodynamic systems often require attaching sensors to the patient at various locations on the patient's body.
Now then, if a patient's hemodynamic readings are abnormal and/or otherwise merit additional consideration, a common next step involves conducting a lower limb Doppler ultrasound examination of the patient's legs, particularly in order to more closely examine a site and extent, if any, of atherosclerosis at the femoral artery. Such determinations are often referred to as “direct” assessments, and they are often conducted by techniques such as duplex imaging, typically through the use of hemodynamic evaluation with Doppler interrogation and ultrasound imaging. Many duplex ultrasound systems include both high and low frequency imaging capabilities, as well as both audible and spectral Doppler evaluation for high and low frequency evaluations.
One of the difficulties in using two different and independent systems, as described above (e.g., one for hemodynamic assessment, and another for ultrasound and/or other imaging), however, is that both systems are often needed for a single patient. For example, one clinician may use a hemodynamic system to provide an initial diagnosis of PAD, while another may then use an ultrasound imaging system to further the analysis—such that the two systems are used independently and separately, and oftentimes by different caregivers. Moreover, the two different tests may require the patient to have two or more separate appointments, perhaps on different dates. The patient could also be required to move between healthcare rooms and/or facilities for the different tests. The equipment could also need to be moved from one patient's room to another patient's room, bringing in the hemodynamic system first, followed by the ultrasound (or other imaging system) next—or vice versa. This can lead to disadvantages of, among other things, wasting space, time, cost, capitol equipment allocations, as well as personnel and/or other inefficiencies. As a result, it is not uncommon for caregivers to chose only one of direct assessment or indirect assessment as a matter of convenience and/or logistics, leading to compromised patient exam quality. Accordingly, at least one or more of patients, healthcare providers, and/or healthcare facilities are thereby inconvenienced.
Moreover, when both systems are utilized on a single patient, the data generated from the separately utilized systems is received separately, evaluated separately, and provided in separate reports. Accordingly, a single, integrated report combining the findings of the hemodynamic system and the imaging system would be advantageous. Moreover, the amount of time required to carry out and process separate testing systems is considerable.
As a result of at least the foregoing, it would be advantageous to have an overall integrated system that combines patient workflows and medical evaluations from hemodynamic and imaging systems, such as ultrasound imaging systems, particularly for monitoring PAD. And a single, comprehensive report that combines data from both systems would also be advantageous for patients, healthcare providers, and/or healthcare facilities.